In Sickness, Marriage May Not Boost Health

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Marriage is good for the health, but it isn't so beneficial "in
sickness," new research finds.

Previous studies have consistently found that people who are
married
report better health than people who aren't. But marriage may
not do much to help people who are seriously ill, the study
finds. On top of that, married people overestimate how healthy
they are.

"The married don’t seem to report their health as being poor
until they've already developed much more severe health
problems," study researcher Hui Zheng, a sociologist at Ohio
State University, said in a statement. "They have a different
threshold for what they consider to be bad health compared to
unmarried people."

Healthy marriages?

Zheng and his colleagues analyzed data from 789,000 people who
took the National Health Interview Survey from 1986 to 2004. The
U.S. Census Bureau runs the survey, which has been ongoing since
1957.

One survey question asked respondents to rate their own health as
either excellent, very good, good, fair or poor. This self-report
has been shown to be a very accurate portrayal of a person's
physical health, and in some cases, Zheng said, can be a better
predictor as to whether someone will die in the short term than a
doctor's diagnosis.

They found that, in general, married
people were less likely to die within three years than people
in all other categories, including those who were never married,
divorced, widowed or separated. Someone who has never been
married who self-rates his or her health as "excellent" is twice
as likely to die within three years as a married person in
excellent health, for example. (These findings took into account
demographics such as age.)

In sickness

But there was some nuance to the health question. The poorer a
person's health at the study's start, the less their marital
status mattered in mortality risk.

For never-married people, each decrease in health from
"excellent" to "very good" and down was linked to a 12-percent
decrease in the short-term risk of death compared with married
people in the same category. In the "poor" health category, there
was no mortality difference between married and unmarried people.

"These results suggest that marriage may be important for the
prevention of disease, but not as helpful once people become
seriously ill," Zheng said. "That's why we see a protective
effect of marriage when people are in excellent health, but not
when they are in poor health."

The researchers found the same results when they used a
different, objective measure of health, the ability to handle
routine activities of daily living such as bathing and cooking.

Married people don't rate their health as poor until they've
developed more severe health problems than unmarried people, the
researchers found. So someone who is married and says they're in
poor health may actually be worse off than a singleton in poor
health. The difference could help explain why the
benefit of marriage seems to vanish in the poor-health
category.

Social support received from a spouse may make it less obvious to
a person that their health is deteriorating, Zheng said. But the
end result is still premature death.

"Marriage is helpful in persuading people to adopt a healthy
lifestyle that can lead to a longer life," Zheng said. "But it is
not as useful in helping people recover from a serious illness."

The researchers report their results in the March issue of the
Journal of Health and Social Behavior.